A clinical study on the cervical lymph node metastasis of maxillary sinus carcinoma

Objective: to improve the management of maxillary sinus carcinoma, we retro spectively investigated the significance of cervical lymph node metastasis in our treated cases and discussed how to deal with the cervical lymph node metastasis as a prognostic factor. Methods: medical records of 118 patient s with maxillary sinus carcinoma diagnosed and treated in our institute fro m 1982 to 1997 were retrospectively reviewed. Tumors were staged according to UICC classification 1987. The cumulative survival was analyzed by the Ka plan-Meier method. Generally, the patients had undergone preoperative radio therapy and surgery. We examined the cervical lymph node metastasis detecte d at the first examination and the subsequent cervical lymph node metastasi s in relation to the prognoses. Results: the incidence of cervical lymph no de metastasis at the initial diagnosis was 7.9% (n = 9), and that of second ary cervical lymph node metastasis without recurrence at the primary site a fter the first treatment was 8.3% (n = 9). In most cases, we observed metas tasis to the lymph nodes in the submandibular region and in the jugular cha in. The result of treatment of cervical lymph node metastasis was grave. Am ong the patients with cervical lymph node metastasis detected at the first examination, four patients developed local recurrence and three patients de veloped distant metastasis. On the other hand, among those with secondary c ervical metastasis, three patients developed neck recurrence and three pati ents developed distant metastasis, but no local recurrence. Conclusions: in the cervical metastasis of maxillary sinus carcinoma, it is important to t reat the primary lesion completely. In addition to it, we should control ce rvical metastasis and careful neck dissection is required. For the patients with cervical lymph node metastasis, it is necessary to consider the furth er treatment of distant metastasis. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.